Haitians struggle after Hurricane Matthew

People throughout Haiti's devastated southwest peninsula formed makeshift brigades Tuesday to clear debris and try to regain some semblance of their pre-hurricane lives as anger grew over the delay in aid for remote communities more than a week after the Category 4 storm hit.

A community group that formed in the southern seaside community of Les Anglais began clearing tree limbs from streets and placing them into piles while others gathered scraps of wood to start rebuilding homes destroyed by Hurricane Matthew.

A man walks past debris left by Hurricane Matthew in Dame-Marie, Haiti, Monday, Oct. 10, 2016. Nearly a week after the storm smashed into southwestern Haiti, some communities along the southern coast have yet to receive any assistance, leaving residents who have lost their homes and virtually all of their belongings struggling to find shelter and potable water. (AP Photo/Dieu Nalio Chery)

Young men whose home was destroyed by Hurricane Matthew peer out of a tent as they awake for the day in the courtyard of a school where they have sought shelter, in Port Salut, Haiti, Monday, Oct. 10, 2016. While some families were able to recover mattresses, furniture, and a few household goods from under the mud, others lost everything. The scores of people sheltering at this school have been told they have one more week before they have to move out so classes can restart. (AP Photo/Rebecca Blackwell)

Carpenter James Nassau donned a white construction helmet as he rebuilt a neighbor's wall with recycled wood, hoping to earn a little money to take care of 10 children, including those left behind by his brother, who died in the storm.

"My brother left five kids, and now I've got to take care of them," he said. "Nobody has come to help."

The scene repeated itself across small seaside and mountain villages dotting the peninsula, where people pointed out helicopters buzzing overhead and questioned why they haven't received any help.

A woman pauses as she sweeps the ground where her home once stood after the passing of Hurricane Matthew in Jeremie, Haiti, Wednesday, Oct. 12, 2016. Nearly a week after the storm smashed into southwestern Haiti, some communities along the southern coast have yet to receive any assistance, leaving residents who have lost their homes and virtually all of their belongings struggling to find shelter and potable water. (AP Photo/Dieu Nalio Chery)

A woman looks up as a worker uses salvaged sheets of mangled metal, full of holes, to create a makeshift roof atop her home damaged by Hurricane Matthew, in Port-a-Piment, Haiti, Monday, Oct. 10, 2016. (AP Photo/Rebecca Blackwell)

A man repairs a roof that was destroyed by Hurricane Matthew in Dame-Marie, Haiti on Monday, Oct. 10, 2016. (AP Photo/Dieu Nalio Chery)

Israel Banissa, a carpenter who lives near the small mountain town of Moron, said a Red Cross assessment team stopped outside his village to ask people questions but didn't leave any supplies.

"There's no aid that's come here," he said as he sawed wood to help rebuild his home and dozens of others. "I don't think they care about the people up here."

The U.N. humanitarian agency in Geneva has made an emergency appeal for nearly $120 million in aid, saying about 750,000 people in southwest Haiti alone will need "life-saving assistance and protection" in the next three months. U.N. officials said earlier that at least 1.4 million people across the region need assistance and that 2.1 million overall have been affected by the hurricane. Some 175,500 people remain in shelters.

People try to get off a boat carrying aid as national police arrive to secure the vessel carrying supplies as it docks in Jeremie, Haiti, Wednesday Oct. 12, 2016, after Hurricane Matthew hit the area. The U.N. envoy for Haiti says the impoverished Caribbean nation is facing "a humanitarian tragedy and an acute emergency situation" with 1.4 million people needing immediate help. (AP Photo/Dieu Nalio Chery)

The National Civil Protection headquarters in Port-au-Prince raised the official nationwide death toll to 473, which included at least 244 deaths in Grand-Anse. But local officials have said the toll in Grand-Anse alone tops 500.

Those who survived the storm still faced great challenges, including going days without food.

Elancie Moise, an agronomist and director for the Department of Agriculture in southern Haiti, said between 80 to 100 percent of crops have been lost across the southern peninsula.

"Crisis is not the word to describe it," he said. "You need a stronger word. It is much worse. There is no food for people to eat."

Food was slowly reaching remote communities, but there was also a growing need for medical supplies.

A doctor adjusts a bottle of serum for patients at a cholera center in Anse D'Hainault, Haiti, Tuesday, Oct. 11, 2016. The U.N. said Hurricane Matthew has increased the risk of a "renewed spike" in the number of cholera cases. (AP Photo/Dieu Nalio Chery)

In the western seaside village of Dame Marie, patients with festering wounds lay silently on beds at the main hospital waiting for medicine a week after the storm hit.

Among them was Beauvoir Luckner, a cobbler and farmer who walked 12 kilometers (seven miles) in three days after a tree fell on his house, crushing his leg and killing his mother. The leg might have to be amputated, but all doctors can do is clean his wounds because the hospital has run out of everything, including painkillers.

Meanwhile, Luckner lay on a mattress with no sheets, a bandage wrapped around his left leg.

"It took a lot of misery to get here and now that I'm here, there's still misery," he said.

Concern also was growing about an increase in cases of cholera, which has already killed roughly 10,000 people and sickened more than 800,000 since 2010.

Dr. Dominique Legros, a top cholera official at the World Health Organization, said Tuesday that the agency was sending 1 million doses of cholera vaccine to Haiti and that safe drinking water and treatment of those affected by the disease were top priorities.

A victim of cholera receives treatment at the state hospital after Hurricane Matthew, in Jeremie, Haiti on Sunday, Oct. 9, 2016. Aid has begun pouring into the hard-hit town, where thousands of homes were damaged or destroyed and many people were running low on food and facing an increased risk for cholera. ( AP Photo/Dieu Nalio Chery)

Victims of cholera receive treatment at a cholera center in Anse D'Hainault, Haiti, Tuesday, Oct. 11, 2016. The U.N. said Hurricane Matthew has increased the risk of a "renewed spike" in the number of cholera cases. (AP Photo/Dieu Nalio Chery)

The daughter of 84-year-old Armant Germain replaces the sheets on her bed, in the cholera ward at a hospital in Les Cayes Haiti, Tuesday, Oct. 11, 2016. Health authorities have warned that Hurricane Matthew has created conditions that are likely to cause an increase in the deadly waterborne cholera disease. (AP Photo/Rebecca Blackwell)

A boy suffering from cholera receives treatment at a cholera center in Anse D'Hainault, Haiti, Tuesday, Oct. 11, 2016. The U.N. said Hurricane Matthew has increased the risk of a "renewed spike" in the number of cholera cases. (AP Photo/Dieu Nalio Chery)

Speaking to the U.N. Security Council, the U.N. envoy for Haiti, Sandra Honore, said the health impact of Hurricane Matthew "cannot be overestimated."

Already fragile water and sanitation infrastructure has been severely damaged, resulting in the absence of drinking water and "a very high level of infections from diarrheal disease, including, but not exclusively, cholera," Honore said.

She said hundreds of suspected cholera cases have been reported, and "we are already seeing the first deaths."

U.N. Secretary-General Ban Ki-moon told reporters in New York on Monday that a "massive response" was needed to help Haiti emerge from the storm's aftermath. He noted that crops and food reserves were destroyed and that at least 300 schools have been damaged.

"At least 1.4 million people need assistance at this time," he said. "These numbers and needs are growing as more affected areas are reached. Tensions are already mounting as people await help."